a description of additional responsibilities to the wider NHS and profession. For example, being a medical director, clinical director, clinical governance/audit lead, undergraduate/postgraduate dean, etc.

a description of external duties (eg trade union duties, work for a royal college, etc).

any arrangements for additional PAs or sessions, over and above your standard contract

any details of regular private work

any agreed arrangements for carrying out regular fee-paying services

any special agreements or arrangements regarding the operation or interpretation of the job plan

accountability arrangements

any agreed flexible working arrangements.

If you are applying for your first post, be aware that it should include a proposed job plan in the application pack. If one is not included, you should ask to see one.

Principles of the job planning process

The process should be collaborative and cooperative and the job plan must be agreed, and not imposed. It should focus on enhancing outcomes for patients while maintaining service efficiency.

Job planning is an ongoing process, you do not need to wait for an annual review to address concerns with your job plan. You or your employer can request an interim review if:

duties or needs have changed

you are concerned about whether your objectives can be met.

Programmed activities (PAs)

PAs are blocks of time, usually equivalent to four hours, in which contractual duties are performed. There are four basic categories of contractual work:

direct clinical care (DCC)

supporting professional activities (SPAs)

additional responsibilities

external duties.

A job plan will set out how many PAs you are working and how many will be used undertaking these different types of work.

A significant proportion of your time may be spent on DCC. Direct clinical care work is any work that involves the delivery of clinical services and administration directly related to them.

However, a job plan will cover other activities that are essential to your professional development and to the wider NHS.

Supporting professional activities (SPAs)

SPAs underpin clinical care and contribute to ongoing professional development as a clinician. This includes activities like:

teaching and training

medical education

continuing professional development

clinical governance

appraisal and revalidation.

The amount of time in an individual’s job plan allocated to SPAs will partly depend on their grade.

Local and national variation

For consultants, there is some national variation. The wording in the model contracts for England and Northern Ireland state that job plans:

’Will typically include an average of 7.5 programmed activities for direct clinical care duties and 2.5 programmed activities for supporting professional activities’.

The same split is set out in the Scottish consultant terms and conditions.

In the Welsh model contract, three sessions of SPA time are recommended.

All SAS doctors are contractually entitled to a minimum of one PA or session of SPA time, though some have negotiated the same SPA time as their consultant colleagues and this will depend on experience and career level.

Local and national variation sometimes happens and a number of employers have sought to reduce the amount of SPA time allocated to doctors.

The best way to defend your SPAs is to make it clear to your employer what work is likely to stop if your SPAs are cut back and what objectives are associated with this work.

Additional or extra programmed activities or sessions (APAs/EPAs)

A doctor working full time will work 10 PAs or sessions per week. You are not obliged to agree to a contract containing a greater number of PAs or sessions.

An employer may offer you APAs or EPAs in addition to your contracted number of PAs or sessions. This is to reflect spare professional capacity, agreed, regular additional duties or activities not contained within your standard contract. They can be used, for example, to recognise an unusually high routine workload, or to recognise additional responsibilities.

If you agree to additional PAs over and above your standard contract, it may be beneficial to seek a separate written agreement or contract. This agreement should set out the purpose and duration of these activities. It should also set out the specific pay arrangements you have negotiated for undertaking this extra work.

The job planning process should be able to accommodate these separate arrangements, however we know that many doctors’ additional work is simply rolled up into their standard contract and job plan.

It can be useful keep your standard workload and additional activity separate, so that if you later decide to give up this extra activity it will be clear what work you will no longer be doing.

Additional responsibilities and external duties

Additional responsibilities are duties carried out on behalf of the employer or another relevant body and which are beyond the normal range of SPAs.

External duties are not done directly for your NHS employer.

Tracking your time

The BMA offer our members a job planning tool called Dr Diary for NHS consultants, SAS doctors and medical academics. It’s a key part of the job planning process as it allows you to track your time accurately and evidence your workload.

Setting objectives

Objectives must be agreed by you and your employer, where agreement cannot be reached, this may be subject to mediation or appeal.

It is essential that you are confident that any objectives you agree are achievable. Failure to achieve objectives is one of the factors that entitle the employer to withhold pay progression for that year.

Things to consider when setting objectives:

the outcome of the objective should be within your individual control

they should be at a level which you are confident you will be able to deliver

you should be able to provide evidence where necessary, that the objective has been delivered

ensure your objectives are realistic, appropriate to your role and consistent with your professional obligations in terms of quality of care.

Discussion of objectives provides you with an opportunity to raise the issue of supporting resources. You can only achieve your objectives if your employer provides the necessary support and resources. It's essential such resources are recognised and reflected in your job plan.

Team-based job planning

A team-based job plan is a job plan which is agreed collectively across teams of doctors. However, job plans are a contractual document which can only be agreed on an individual basis between consultant and the employer.

Therefore, a ‘team job plan’ needs to be done in a way which is compatible with the employer’s obligations for individualised job planning under the terms and conditions of services for consultants and SAS doctors.

Potential outcomes from a team-based job plan

Could strengthen an individual’s negotiating abilities if they knew that their position is shared and supported by colleagues.

Management may adopt a broadly similar approach to consultants across a team.

Job planning meetings could be easier if a broad measure of consensus has already been achieved in advance by collective discussions.

Doctors should avoid agreeing team objectives in their individual job plans. This is because the achievement of these will often not be within their individual control.